TY - JOUR
T1 - Transcranial Doppler ultrasonography predicts cardiovascular events after TIA
AU - Holzer, Katrin
AU - Sadikovic, Suwad
AU - Esposito, Lorena
AU - Bockelbrink, Angelina
AU - Sander, Dirk
AU - Hemmer, Bernhard
AU - Poppert, Holger
PY - 2009/7/30
Y1 - 2009/7/30
N2 - Background: Transient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA. Methods: 176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of 27 months, new vascular events were recorded. Results: 22 (13.8%) patients experienced an ischemic stroke or TIA, 5 (3.1%) a myocardial infarction or acute coronary syndrome, and 5 (3.1%) underwent arterial revascularization. ECD revealed extracranial ≥ 50% stenosis or occlusions in 34 (19.3%) patients, TCD showed intracranial stenosis in 15 (9.2%) and collateral flow patterns due to extracranial stenosis in 5 (3.1%) cases. Multivariate analysis identified these abnormal ECD and TCD findings as predictors of new cerebral ischemic events (ECD: hazard ratio (HR) 4.30, 95% confidence interval (CI) 1.75 to 10.57, P = 0.01; TCD: HR 4.73, 95% CI 1.86 to 12.04, P = 0.01). Abnormal TCD findings were also predictive of cardiovascular ischemic events (HR 18.51, 95% CI 3.49 to 98.24, P = 0.001). Conclusion: TIA patients with abnormal TCD findings are at high risk to develop further cerebral and cardiovascular ischemic events.
AB - Background: Transient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA. Methods: 176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of 27 months, new vascular events were recorded. Results: 22 (13.8%) patients experienced an ischemic stroke or TIA, 5 (3.1%) a myocardial infarction or acute coronary syndrome, and 5 (3.1%) underwent arterial revascularization. ECD revealed extracranial ≥ 50% stenosis or occlusions in 34 (19.3%) patients, TCD showed intracranial stenosis in 15 (9.2%) and collateral flow patterns due to extracranial stenosis in 5 (3.1%) cases. Multivariate analysis identified these abnormal ECD and TCD findings as predictors of new cerebral ischemic events (ECD: hazard ratio (HR) 4.30, 95% confidence interval (CI) 1.75 to 10.57, P = 0.01; TCD: HR 4.73, 95% CI 1.86 to 12.04, P = 0.01). Abnormal TCD findings were also predictive of cardiovascular ischemic events (HR 18.51, 95% CI 3.49 to 98.24, P = 0.001). Conclusion: TIA patients with abnormal TCD findings are at high risk to develop further cerebral and cardiovascular ischemic events.
UR - http://www.scopus.com/inward/record.url?scp=69249206856&partnerID=8YFLogxK
U2 - 10.1186/1471-2342-9-13
DO - 10.1186/1471-2342-9-13
M3 - Article
C2 - 19642970
AN - SCOPUS:69249206856
SN - 1471-2342
VL - 9
JO - BMC Medical Imaging
JF - BMC Medical Imaging
M1 - 13
ER -